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Healthcare Associated Infections

Healthcare Associated Infections Articles:

Author/s (year)


Aims or


Sample/ setting


Key stakeholders and their roles

Design/ methods


Type of paper

Main findings


Primary argument

Strengths and limitations of the paper
Article 1 Russo et al, 2015


This article provides a detailed information showing an overview of already established international and Australian state wide Healthcare Associated Infections in relation to surveillance programs and also provide a strong recommendation for a coordinated HAI surveillance program in Australia.  The study focuses on public hospitals where there are HAIs. Literature reviews from previous authors were used to examine existing HAI surveillance programs internationally and nationally.

Overall, the study made extensive use of qualitative data analysis.

From the findings, it was deduced that the process of HAI surveillance is helpful in the reduction of any HAIs occurrence.

Additionally, the authors argue that the current national surveillance program in Australia is not effective and also ambiguous to avert the epidemic situation. Therefore, there should be an improvement.

Strength: The use of existing literature review made the research qualitative and a qualitative information was provided for further future review

Limitation: The research only focuses on the use of qualitative analysis.

Article 2 Tan and olive (2015)

Saudi Arabia

The purpose was to support and promote hand hygiene in hospitals against healthcare associated infections  A total of 87 Healthcare practitioners working in hospitals fully participated. A qualitative research method was used through the distribution of standardized survey question. The findings showed that healthcare practitioners are knowledgeable about healthcare associated infections and hand hygiene and also believed chances are that hospitalized patients could still be infected with any HAIs. Strength: many  participants reduced bias, the use of medical practitioners

Helped provide reliable information.

Limitation: not all participated fully participated.

Article 3 Leas et al, 2015


To demonstrate the needs of keeping the hospital environment and other hard surfaces within the hospital clean. The settings used are the hospital room and its environment.

Other samples used include the clinical studies based on deep examination of the cleaning and related disinfection of the high-touch surfaces in the hospital rooms or wards of the adult inpatients.

Some key stakeholders involve the representatives from environmental service management, about 12 of them we interviewed.

Gray literatures were used for this study, as well as other related literatures in peer-reviewed journal. In addition, databases and websites related to some institutions were used to obtain data. There were discussions with key informants to also obtain related information.

The medical libraries were used to obtain other published literatures.

The primary argument is that hard surfaces in the hospital rooms can cause HAIs.

From the study, about eighty different studies were looked into. These include discussions n modalities, monitoring strategies, the challenges/facilitator relative to the implementation of HAIs control, and the use of nonrandomized historical and concurrent controls.

The result shows that surface contamination is a basis in all the studies.

Strength: The research was comparative-effectiveness studies which defined the goals of exploring studies about the impacts of HAIs in the environment, hospital rooms, and resources. It was able to explore very relative and quality paper.

Limitation: The comparative-effectiveness studies were limited to the comparison of disinfection modalities and also the monitoring strategies.

Article 4 Klevens et al 2002 US There is the need to appropriately define the total estimate or approximate number national healthcare associated infections and the death rates from the impacts of HAIs in the United States Hospital. The sample data include the National Nosocomial Infections Surveillance (NNIS) system data, data obtained from the Centre for Disease Control and Prevention, related data obtained from the National Hospital Discharge Survey, the American Hospital Association Survey data were used to add up to the existing data. Data pertaining to the death caused by HAIs was obtained from NNIS for the death estimation. This research work employs a multistep approach where about three data sources were employed. Additionally, various data sources were employed to put together the required estimate in the objective of the research. The authors were able to obtain some estimate on values related those affected with HAIs in the United States Hospital; this included an estimate value of newborns in their nurseries as well as adults and children within and outside of the ICUs. Additionally, there was an approximate rate of death associated with HAIs and other related epidemic situations. Strength: The research was able to extract adequate data relative to the objectives and it was able to establish the significant reasons of morbidity and mortality rates in the United States of America.

Limitation: The research was only based on existing data stored at the national level, no fresh data was developed.

Article 5 Fashafsheh et al., 2015


 The motivation of this study is spurred out of the support for the World Health Organization (WHO) hand-hygiene campaign to fight against HAIs.

The study also examines critically the perception healthcare practitioners have towards hand-hygiene in preventing HAIs. And specifically the perceptions related to HAIs and hand-hygiene generally

 An important aspect of this study is the use of the Perception Survey for the Healthcare Workers questionnaire which was developed and recommended by the WHO.

Therefore, the major stakeholder is the WHO.

And since the research also used a questionnaire, nurses were involved to answer the questions.

The study follows a cross sectional method based on information obtained between November 2014 and January 2015 in various governmental hospitals in Palestine.

Pre tested questionnaire.

The collected data were carefully checked, programmed into codes and transferred to SPSS for evaluation and analysis.

The authors aimed to use the study to assess the level at which healthcare professionals were knowledgeable in their practice and how much they carry out infection control in the government hospitals in Palestine. Strength: The study was able to demonstrate the high level of knowledge among nurses in these hospitals.

Limitation: As much as the nurses were knowledgeable about Infection control, their practical experiences are low, therefore, the author recommends  education programs and more training to help the nurses advance better.

Literature Review: Healthcare Associated Infections

Health Associated Infections (HAIs) refer those popular, considerable and a preventable patient safety Healthcare Associated Infectionsconcern today. Studies have shown that about 180,000 patients undergo healthcare associated infections each year that extend their hospital stay and exhaust about two million hospital bed days. The HAIs have impacted the country negatively, as many are suffering from morbidity and there have been increased mortality risk rate. However, to alleviate and address the risks of suffering from healthcare associated infections, various HAIs programs have been put in place. For this reason, this paper will summarize, analyse, and critique five research studies regarding Health Associated Infections.

The authors, Russo et al., (2015) demonstrated an effective use of existing literatures in their quest to explore the significance of surveillance program for the HAIs prevention in all states in Australia. They argued that there is no formalised and comprehensive provision for any national surveillance program against HAIs in Australia, which in turn affects the surveillance program in the country. Their major objective was to ensure there is a provision of the statement of purpose of already constituted international and Australian state-wide surveillance programs to fight against HAI, thus, the recommendation of a roadmap to develop the national surveillance program directed towards HAIs which is not currently formalised in Australia as a whole. Most emphatically, their opinion is that the provision of an organized national program against HAIs to assist the improvement of citizens’ understanding of the epidemiology of Health Associated Infections present in Australia. Therefore, there is need for a provision of quality data directed towards performance monitorung, which will help ensure that the HAI prevention intervention schemes are focused strongly and appropriately. Although, the current programs undertaken in Australia may seem ambiguous and the HAI rates obtained in Australia are uncertain to them, I believe that every government work tirelessly to avert epidemic situations in their country. The Australian government is still at this also.

Furthermore, Tan and Olivo (2015) in their paper “Assessing Healthcare Associated Infections and Hand Hygiene Perceptions amongst Healthcare Professionals” were able to explore the importance of reducing the morbidity, prolonged hospital stay, painful mortality rates, the increased healthcare costs through proper hand hygiene as well as antibiotic resistance relative in acute and long term healthcare facilities. Their objective in this study was to typically evaluate the perception related to hand-hygiene among doctors and nurses in Saudi Arabia, which they believe is one of the causes of increased HAIs in the country. They were able to gather their data using a questionnaire set up by the World Health Organization (WHO), and obtained quality results of about 87 respondents in the study. According to Tan and Olivo, (2015) their studies demonstrated that the hospital is a potential risk of being infected with HAIs, and proper hand hygiene is the only most effective method to fight against HAIs in the hospital environment. After thorough assessment, it is realized that all the health workers in the setting employed are fully aware of HAIs and proper hand hygiene in relation to HAIs. They further concluded that performing hand hygiene will help the alleviate HAIs. I believe that every health professional understand the potential risks they undergo in their profession, and if they do not ensure adequate hand hygiene, then they are not qualified for their profession. The study is relatively adequate for its recommendation – observational studies are important.

The third study is a comprehensive report conducted for the “Agency for Healthcare Research and Quality” in the Department of Health and Human Services, United States. The writers, Leas et al., (2012) carried out a systematic research from various sources, libraries, and other resources to explore the fact that environmental cleaning will prevent HAIs. According to Leas et al., (2012) clinical studies were employed in evaluating the cleaning and medical treatment against microorganism of high-touch surfaces in the hospital rooms that accommodate adult patients. They opined that it is important to clean the hard surfaces relevant to reduce any the risk of HAIs, demonstrating various methods to clean and monitor cleanliness, even when some of these methods are not well understood. According to their findings, they included about eighty studies. While forty-nine studies analysed cleaning modalities, such as self-disinfecting surfaces, chemical agents, and no-touch technologies, fourteen studies analysed the monitoring strategies, then sixty-five studies were based on nonrandomized concurrent or historical controls and 57studies featured the outcome of surface contamination. The study concludes that comparative-effectiveness studies are inadequate enough for comparing disinfection modalities, and the available strategies for monitoring are limited. They further recommended that future research should be able to examine and compare newly developing strategies and address accompanying challenges in the cleanliness of surfaces against the risk of pathogen transmission.

In an attempt to estimate the level of criticality and severity HAIs have caused to the American citizen, Klevens et al., (2002) were able to undergo a research to gather this data. They utilized a multi-step approach to achieve their results, since there was no source of nationally representative data on Healthcare Associated Infections; they were able to also obtain three data sources. One of the major sources employed is the National Nosocomial Infection Surveillance (NNIS) system, this source provided information gathered by the “Centres for Disease Control and Prevention” covering data between 1990 and 2002. Also, another source utilized was the data obtained from “National Hospital Discharge Survey” in 2002 and data from the “American Hospital Association Survey” conducted in 2000. In addition, the percentages of patients whose deaths are associated with HAI from the NNIS data were used to obtain the mortality rates. The results obtained from this finding is that there was a massive number of patient suffering from one HAI or the other and this accounted to about 1.7 million, where about 33,269 were newborns and 417, 946 adults and children, and about 1,266,851 children and adults within and outside of the ICUs respectively. The death estimation within that period was about 98,987 with various causes from HAIs.

Finally, Fashafsheh et al., (2015) were able to demonstrate the level of the knowledge and practice of nursing staff regarding infection control measures in the Palestinian hospitals through a cross sectional study. They carried out their studies in government hospitals   and of course obtained results from their respondents through questionnaire tested on 271 healthcare professionals selected by purposive sample. Using SPSS, they collected, collated, coded, and transferred their results for analysis and thus, obtained results. From their results, it is apparent that over 80% of nurses were fairly knowledgeable about infection control measure, and about 91.1% have a good practice of this cause. Their studies concluded that regardless of the good practice level of the nurses, the nurses had a limited knowledge level of infection control measures. They further recommended that nurses should be updated with the knowledge and practice through continuing in-service program that will educate them excellently.

Overall, these articles are somewhat related and were able to buttress the main ideas behind HAIs. The first article emphasises the need for an effective surveillance program in Australia, the second evaluated how important healthcare professionals must take hand hygiene important, the third emphasises environmental cleanliness against HAIs, the fourth gathered data on the impacts of HAIs and the fifth explored fifth evaluated the level of healthcare professionals’ knowledge of HAIs and its control. Based on these facts, the writers demonstrated control and prevention of HAI in their immediate societies.

Also Study: Quality Improvement Tools in Healthcare Industry

  • Fashafsheh, I., Ayed, A., Eqtait, F., & Harazneh, L. (2015). Knowledge and Practice of Nursing Staff towards Infection Control Measures in the Palestinian Hospitals . Journal of Education and Practice, 6(4), 1–13. Retrieved from https://files.eric.ed.gov/fulltext/ej1083751.pdf
  • Klevens M, Edwards J, Horan, T., Gaynes, R., Pallock, D., & Cardo, D. (2002). Estimating Health Care-Associated Infections and Deaths in U.S. Hospitals, 2002 . Public Health Report, 1–7. Retrieved from https://www.cdc.gov/hai/pdfs/hai/infections_deaths.pdf
  • Leas, B., Sullivan, N., Han, J. H., Pegues, D. A., Kaczmarek, J., & Umscheid, C. (2015). Environmental Cleaning for the Prevention of Healthcare-Associated Infections . AHRQ Publication, 15, 1–121. Retrieved from https://www.effectivehealthcare.ahrq.gov/ehc/products/592/2103/healthcare-infections-report-150810.pdf
  • Russo, P. L., Cheng, A. C., Richards, M., Graves, N., & Hall, L. (2015). Healthcare-associated infections in Australia: time for national surveillance. Aust. Health Review Australian Health Review, 39(1), 37. https://doi.org/10.1071/ah14037
  • Tan, A. K., & Olivo, J. (2015). Assessing Healthcare Associated Infections and Hand Hygiene Perceptions amongst Healthcare Professionals. International Journal of Caring Sciences, 8(1), 1–7. Retrieved from https://citeseerx.ist.psu.edu/viewdoc/download?doi=

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